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02/06/2018 TUE 13: 04 FAX Fast water Hester Ia003/007 <br /> Og.LI q'l <br /> "IIPPERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING I SIGN I SPRINKLER/DEMOLITION <br /> �_ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 . <br /> (P)425-257-8510 I FAX 425-257-8857 I(E)everetteps{aleverattwe.gov I www.everettwa.govipermils • <br /> Blue or Black Ink Oni. Please PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: ;1 , NI�� /� I /I PROPERTY TAX#: �n% I 1 IS V <br /> LEGAL for new oonatructlon; Short Ptat/eubdivialon i-ot Nom (attach copy of Ione legal description) <br /> TO r T ' CONTA-- <br /> CT INFORMATION <br /> OWNER NAME: TV it S bLC�0/ // 1 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: maw In) gDc .Er. L- <br /> Ct r ' 6TATE , r 2 1)r<9 o J <br /> OWNER PHONE: Tji�5309 CI ( n 1 i OWNERnrEMAIL: <br /> CONTRACTOR NAME; CAST Ai' T� -k SAT l • A. <br /> CONTRACTORADDRESS: STREET \\'r 1.5 h) C'(9 ,Q $ _ ('_ ��A(�0 ]��j <br /> ZIP <br /> CONTRACTOR PHONE: . 0 ' ■O ► CONTRACTOR EMAIL: °V,E,Wl II-S f J, A'1.1. atm Vlll/keir, (j <br /> CONTRACTOR LICENSE*(REQUIRED):-F -C' /0kiCil n FjG CITY OF EVERETT BtisINESS LICENSE#(REQUIRED) tL153 <br /> PRIMARY CONTACT: 0 OWNER (CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: � CONTACT PHONE: 05" ! ' •YM • <br /> -- — 1�/4 �`y�f L- CONTACT EMAIL: W1 I"1-5 0 _ A4firIA QQI` • C/Gvii <br /> BUILDING PERMIT APPLICATION 15 ,}'^ <br /> 14 Existing Use of Rulldrn9: S f Contract Price of Work:$ _ 3�"I w <br /> Proposed Use of Building; I f Heat Source: eikt6as °Eiectric ClOtherr„�,,R _ _ _ <br /> Building Type: ( FR-Detached ❑SFR Attached ❑Duplex _DMuitl-Family-#of Units:___-.. OCommeroral ❑industrial <br /> net?IL, <br /> f I'r*Jeot: ❑Now ©Addition Remodel Repair OT t �1Sipn Osrinkler p ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: L ^ <br /> 3 \11() 0\i6 / 1( \A-Ce, 6 --. E w ov\- �/I c Oct. <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Profaot: __Now_ Addn _Altaratlon _Repa1i Type of Project; New _ddn _Alteration Repair A , <br /> *of Lista Fixtures #Of List of F/xtUres #of Vet of Fixtures #0{ Vet of Fixturee <br /> Fixtures Fixtures Fixtures Fixtures <br /> __ _ _A/C-Air Handling Unite Heat Pump Toilet Be ow Preventer Inside Bide <br /> Forced Alr S/8tems Unit Heater -..iaefr�*f_ nal <br /> ` dipGas Piping Boller Lavato Was r rain ■rinkln! Fountain <br /> Water Heater ,Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&DisposeGrease Trap T <br /> Gas Range Duofina Dishwasher ." _ Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan 'w1711,17^"~;er/Mop/eto.) Other: <br /> BIMIN 1_ p FJ�iR°selog., ST�IIII <br /> emical or .of Heads <br /> AC!NOWLEDWIVI IN7`1 have nsviewed this application and tonin the infosnellon conlslned herein Is tme end correct.Work done pursuant to INS permit must comply with <br /> current federal,state,and local law.The grant/ng of a permit oily authorizes approved work and no aeviat/ons therefrom.Deviation must first be authorized In writing from the <br /> Sullding Offdief before being authorized under any clrcume/ence.lam the owner,or/em authorized by the owner of this property to perform the wodc for which epplfc Egon Is made, <br /> and l comply with the State Contractors Law 71127 RCW end 299.2004 WAC. <br /> 'n g City of Everett Official Use Only <br /> -W <br /> Own' •uthor za. Ag:et Signature Date (t r(Revviseeedd9/2,/LUI <br />